Hypoparathyroidism results from a deficiency of parathyroid hormone and can be hereditary, caused by damage to the parathyroid glands, or due to other issues. It requires lifelong treatment with calcium and vitamin D supplements to prevent complications. Hyperparathyroidism is an excess of parathyroid hormone and can be primary, secondary, or tertiary. It is associated with complications and may require surgery to remove parathyroid tumors. The metabolic syndrome is a clustering of risk factors that increases the risk of heart disease and diabetes. Lifestyle changes like weight loss, increased physical activity, and following a Mediterranean-style diet are the primary interventions.
This document discusses thyroid disorders, hypopituitarism, parathyroid disorders, and metabolic syndrome. It provides definitions, background information, intervention objectives, dietary recommendations, common drug treatments, and potential side effects for each condition. Nutrition education, counseling, and patient education topics are also covered.
Hypoparathyroidism and hyperparathyroidism are disorders related to deficiencies or excesses of parathyroid hormone that affect calcium levels. Hypoparathyroidism results from parathyroid hormone deficiency, causing hypocalcemia. Treatment involves calcium and vitamin D supplementation to normalize calcium levels and prevent complications. Hyperparathyroidism occurs when parathyroid hormone levels are elevated, causing hypercalcemia. Treatment aims to lower calcium levels through a low-calcium diet and drugs that regulate vitamin D and phosphate levels to prevent issues like kidney and bone disease. Parathyroidectomy may be required to cure primary hyperparathyroidism.
Hypopituitarism and hypoparathyroidism are conditions caused by deficiencies in pituitary and parathyroid hormones respectively. Hypopituitarism results from an underactive pituitary gland leading to lack of hormones like growth hormone, ACTH, and gonadotropins. It causes issues like short stature and abnormal body composition. Hypoparathyroidism is due to low PTH levels and causes hypocalcemia. It requires lifelong calcium and vitamin D supplements to prevent complications like tetany. Both conditions are managed through hormone replacement therapy and dietary modifications.
Hypopituitarism is an underactive pituitary gland that results in deficiencies in one or more pituitary hormones. This can cause issues like fatigue, low blood pressure, and short stature in children. Treatment involves hormone replacement therapy and monitoring nutrition to ensure adequate intake of calories, fluids, vitamins, minerals, and macronutrients. Dietary adjustments may be needed to address issues from missing hormones or side effects of medication. Patients require education on meal planning and safety to help manage their condition.
Hyperparahyroidsm is an endocrinal disorder majorly affecting the parathyroid glands which secrete parathyroid hormone and calcitonin.
A condition characterised by excessive secretion of calcium in blood and Bone resorption and inanbility to metabolise calcium in blood.
This document discusses hypothyroidism, hyperthyroidism, and parathyroid conditions. It defines hypothyroidism as underfunctioning of the thyroid gland and discusses its most common causes. It also defines objectives of treatment such as improving energy levels and screening pregnant women. It provides nutrition recommendations including ensuring adequate iodine and vitamin D intake. The document also discusses hyperparathyroidism and hypoparathyroidism, defining them and discussing their causes, objectives of treatment, and related nutrition considerations.
This document discusses hypocalcemia (low calcium levels in the blood). It defines hypocalcemia and describes its clinical manifestations such as muscle cramps and seizures. It lists various causes of hypocalcemia including parathyroid hormone deficiency, pseudohypoparathyroidism, and vitamin D deficiency. The document provides details on evaluating the etiology of hypocalcemia and its treatment including calcium supplementation. It also discusses related conditions like rickets, which is the lack of bone mineralization in children.
This document discusses thyroid disorders, hypopituitarism, parathyroid disorders, and metabolic syndrome. It provides definitions, background information, intervention objectives, dietary recommendations, common drug treatments, and potential side effects for each condition. Nutrition education, counseling, and patient education topics are also covered.
Hypoparathyroidism and hyperparathyroidism are disorders related to deficiencies or excesses of parathyroid hormone that affect calcium levels. Hypoparathyroidism results from parathyroid hormone deficiency, causing hypocalcemia. Treatment involves calcium and vitamin D supplementation to normalize calcium levels and prevent complications. Hyperparathyroidism occurs when parathyroid hormone levels are elevated, causing hypercalcemia. Treatment aims to lower calcium levels through a low-calcium diet and drugs that regulate vitamin D and phosphate levels to prevent issues like kidney and bone disease. Parathyroidectomy may be required to cure primary hyperparathyroidism.
Hypopituitarism and hypoparathyroidism are conditions caused by deficiencies in pituitary and parathyroid hormones respectively. Hypopituitarism results from an underactive pituitary gland leading to lack of hormones like growth hormone, ACTH, and gonadotropins. It causes issues like short stature and abnormal body composition. Hypoparathyroidism is due to low PTH levels and causes hypocalcemia. It requires lifelong calcium and vitamin D supplements to prevent complications like tetany. Both conditions are managed through hormone replacement therapy and dietary modifications.
Hypopituitarism is an underactive pituitary gland that results in deficiencies in one or more pituitary hormones. This can cause issues like fatigue, low blood pressure, and short stature in children. Treatment involves hormone replacement therapy and monitoring nutrition to ensure adequate intake of calories, fluids, vitamins, minerals, and macronutrients. Dietary adjustments may be needed to address issues from missing hormones or side effects of medication. Patients require education on meal planning and safety to help manage their condition.
Hyperparahyroidsm is an endocrinal disorder majorly affecting the parathyroid glands which secrete parathyroid hormone and calcitonin.
A condition characterised by excessive secretion of calcium in blood and Bone resorption and inanbility to metabolise calcium in blood.
This document discusses hypothyroidism, hyperthyroidism, and parathyroid conditions. It defines hypothyroidism as underfunctioning of the thyroid gland and discusses its most common causes. It also defines objectives of treatment such as improving energy levels and screening pregnant women. It provides nutrition recommendations including ensuring adequate iodine and vitamin D intake. The document also discusses hyperparathyroidism and hypoparathyroidism, defining them and discussing their causes, objectives of treatment, and related nutrition considerations.
This document discusses hypocalcemia (low calcium levels in the blood). It defines hypocalcemia and describes its clinical manifestations such as muscle cramps and seizures. It lists various causes of hypocalcemia including parathyroid hormone deficiency, pseudohypoparathyroidism, and vitamin D deficiency. The document provides details on evaluating the etiology of hypocalcemia and its treatment including calcium supplementation. It also discusses related conditions like rickets, which is the lack of bone mineralization in children.
This document discusses vitamin D, calcium, and phosphate metabolism. It covers the roles and regulation of vitamin D, calcium, and phosphate in the body. Vitamin D helps regulate calcium and phosphate levels and is required for bone mineralization. Deficiencies can lead to conditions like rickets, osteomalacia, and osteoporosis. The document also discusses oral implications of these nutritional deficiencies and metabolic bone diseases. Maintaining proper levels of vitamin D, calcium, and phosphate is important for overall health and bone health.
The document discusses calcium metabolism. It states that 99% of calcium in the body is found in bones. Dietary sources of calcium include milk, cheese, fish and vegetables. The daily calcium requirement is 500mg for adults, 1200mg for children, and 1300mg for pregnant/lactating individuals. Calcium is absorbed in the duodenum and regulated by parathyroid hormone, vitamin D, and calcitonin. Disorders of calcium metabolism include hypercalcemia, hypocalcemia, hyperparathyroidism, and hypoparathyroidism.
This document discusses disorders of the parathyroid glands. It covers the anatomy and function of the parathyroid glands, parathyroid hormone, and disorders involving abnormal parathyroid function such as hyperparathyroidism and hypoparathyroidism. Hyperparathyroidism can be primary, secondary, or tertiary and involves excessive PTH production leading to hypercalcemia. Hypoparathyroidism is a deficiency of PTH causing hypocalcemia. Surgical removal of the parathyroid glands can cause hypoparathyroidism as a complication.
The document discusses calcium homeostasis and disorders of calcium and phosphate metabolism. It provides details on:
1. The functions of parathyroid hormone (PTH) and how it regulates calcium levels.
2. Causes of hypocalcemia including hypoparathyroidism and vitamin D deficiency.
3. Causes of hypercalcemia including primary hyperparathyroidism and malignant diseases.
4. How laboratory tests can help diagnose disorders like hypocalcemia and hyperparathyroidism.
Drugs may be used to modify uterine contractions. These include oxytocic drugs used
to stimulate uterine contractions both in the induction of labour and to control postpartum
haemorrhage and beta2 -adrenoceptor agonists used to relax the uterus and prevent
premature labour.
Calcium is an essential mineral that makes up 2% of body weight. Over 99% is stored in bones, with the rest in tissues and plasma. Calcium levels are tightly regulated by parathyroid hormone (PTH), calcitonin, and calcitriol (active vitamin D). PTH increases calcium levels by promoting bone resorption, while calcitonin and calcitriol decrease calcium levels by reducing resorption. Bisphosphonates are used to treat osteoporosis and Paget's disease by inhibiting bone resorption. They decrease osteoclast activity and survival. Calcium supplements are used to treat deficiencies and osteoporosis, while bisphosphonates and calcim
Calcium, phosphorus, and potassium are essential minerals that play important roles in bone health, cell signaling, energy production, and other physiological processes. Calcium is critical for bone structure and strength. Phosphorus is also structural and involved in energy production. Potassium helps nerves and muscles function properly. Deficiencies can lead to bone diseases like rickets or osteomalacia. Maintaining adequate intake through diet or supplements is important for prevention of diseases like osteoporosis and kidney stones.
This document provides information on several polysaccharides and their uses. It discusses the following compounds: calcium gluconate, ferrous gluconate, sorbitol, mannitol, glucosamine, ascorbic acid, lactulose, sucralfate, hetastarch, cyclodextrins, chitin/chitosan, heparin, acarbose, hydroxypropyl methylcellulose, and hyaluronic acid. For each compound it provides details on source, mechanism of action, uses, and in some cases toxicity. The document contains information on the preparation and applications of these polysaccharides in pharmacy and medicine.
This document provides information on disorders of the parathyroid glands. It discusses the anatomy and function of the parathyroid glands, including their role in calcium regulation and production of parathyroid hormone (PTH). It describes primary hyperparathyroidism, which results from excessive PTH production, and its clinical features. The document also covers hypoparathyroidism, which is a deficiency of PTH, and its signs, symptoms and treatment with calcium and vitamin D supplementation. In summary, the document outlines key endocrine disorders of the parathyroid glands, their effects on calcium levels, and management approaches for hyperparathyroidism and hypoparathyroidism.
Parathyroid gland and The pituitary and HypothalamusAmany Elsayed
The parathyroid glands produce parathyroid hormone (PTH) which regulates calcium and phosphorus levels in the blood by increasing their absorption in the intestines, resorption in the kidneys, and mobilization from bones. PTH increases calcium levels while decreasing phosphorus. The thyroid gland produces calcitonin which decreases calcium levels. Vitamin D facilitates intestinal calcium absorption. Hyperparathyroidism is excessive PTH production and can be primary from adenomas or hyperplasia, or secondary from low calcium levels due to kidney disease or vitamin D deficiency. Complications include osteoporosis, kidney stones, and heart disease.
Drug acting on Calcium Presentation .pptxDrSeemaBansal
Calcium is an essential mineral that is important for bone health and many other bodily functions. It is regulated in the body by parathyroid hormone (PTH), calcitonin, and calcitriol, the active form of vitamin D. Calcium levels can be affected by drugs that interfere with absorption or excretion. Calcium is supplemented orally or intravenously to treat deficiencies. PTH and calcitriol work to increase calcium levels while calcitonin works to decrease them. Vitamin D helps regulate calcium levels by facilitating absorption in the intestine.
Agents that affect bone mineral homeostasis paulPaul Ndung'u
This document discusses various agents that affect bone mineral homeostasis. Parathyroid hormone (PTH) and vitamin D principally regulate calcium and phosphate levels. PTH stimulates vitamin D production and bone resorption, while vitamin D promotes intestinal absorption of calcium and phosphate. Other agents discussed include calcitonin, bisphosphonates, estrogens, glucocorticoids, thiazides, fluoride, and phosphate binders, which all act on bone formation, resorption, or mineral levels in various ways to maintain bone mineral homeostasis.
Iron, vitamin B12, and folic acid are essential nutrients that play important roles in red blood cell formation and oxygen transport. Iron deficiency is the most common cause of anemia and can cause fatigue. Vitamin B12 and folic acid deficiencies can lead to megaloblastic anemia and neurological issues if left untreated. These vitamins have important interactions and side effects that require monitoring, especially in high risk groups like pregnant women.
This document provides an overview of hypoparathyroidism, including its definition, types, symptoms, diagnosis, and treatment. Hypoparathyroidism is a rare condition where the parathyroid glands do not produce enough parathyroid hormone, resulting in low calcium and high phosphate levels in the blood. There are several types including acquired, autoimmune, congenital, and idiopathic hypoparathyroidism. Common symptoms include muscle spasms, abnormal sensations, and seizures. Diagnosis involves evaluating calcium, phosphate, and parathyroid hormone levels in the blood. Treatment focuses on calcium and vitamin D supplementation to manage symptoms.
This document discusses vitamin D and hyperparathyroidism. It notes that vitamin D is a fat-soluble vitamin that is converted to its active form in the kidney and regulates calcium levels. Hyperparathyroidism occurs when the parathyroid glands overproduce parathyroid hormone (PTH), which regulates calcium levels. There are three types: primary (excess PTH from parathyroid glands), secondary (increased PTH to compensate for hypocalcemia), and tertiary (PTH secretion becomes unregulated even after correcting the underlying cause). The document outlines the causes, clinical features, investigations, and treatments for each type of hyperparathyroidism.
Vitamins and trace elements deficiency.pptxmohithA9
This document discusses vitamins and trace elements. It provides details on several water soluble vitamins (vitamin B complex and vitamin C) and fat soluble vitamins (vitamins A, D, E, and K). Specific vitamins discussed in more depth include thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pyridoxine (vitamin B6), their roles, food sources, deficiency symptoms and treatments. The document provides in-depth information on the classification, functions, deficiency and treatment of several important vitamins.
Healthcare for working women should focus on providing nutritious snacks and lunches to support wellbeing, as diet can impact health and weight. Employers should implement policies and management strategies to promote healthy eating and maintaining a healthy weight for female employees.
This document discusses vitamin D, calcium, and phosphate metabolism. It covers the roles and regulation of vitamin D, calcium, and phosphate in the body. Vitamin D helps regulate calcium and phosphate levels and is required for bone mineralization. Deficiencies can lead to conditions like rickets, osteomalacia, and osteoporosis. The document also discusses oral implications of these nutritional deficiencies and metabolic bone diseases. Maintaining proper levels of vitamin D, calcium, and phosphate is important for overall health and bone health.
The document discusses calcium metabolism. It states that 99% of calcium in the body is found in bones. Dietary sources of calcium include milk, cheese, fish and vegetables. The daily calcium requirement is 500mg for adults, 1200mg for children, and 1300mg for pregnant/lactating individuals. Calcium is absorbed in the duodenum and regulated by parathyroid hormone, vitamin D, and calcitonin. Disorders of calcium metabolism include hypercalcemia, hypocalcemia, hyperparathyroidism, and hypoparathyroidism.
This document discusses disorders of the parathyroid glands. It covers the anatomy and function of the parathyroid glands, parathyroid hormone, and disorders involving abnormal parathyroid function such as hyperparathyroidism and hypoparathyroidism. Hyperparathyroidism can be primary, secondary, or tertiary and involves excessive PTH production leading to hypercalcemia. Hypoparathyroidism is a deficiency of PTH causing hypocalcemia. Surgical removal of the parathyroid glands can cause hypoparathyroidism as a complication.
The document discusses calcium homeostasis and disorders of calcium and phosphate metabolism. It provides details on:
1. The functions of parathyroid hormone (PTH) and how it regulates calcium levels.
2. Causes of hypocalcemia including hypoparathyroidism and vitamin D deficiency.
3. Causes of hypercalcemia including primary hyperparathyroidism and malignant diseases.
4. How laboratory tests can help diagnose disorders like hypocalcemia and hyperparathyroidism.
Drugs may be used to modify uterine contractions. These include oxytocic drugs used
to stimulate uterine contractions both in the induction of labour and to control postpartum
haemorrhage and beta2 -adrenoceptor agonists used to relax the uterus and prevent
premature labour.
Calcium is an essential mineral that makes up 2% of body weight. Over 99% is stored in bones, with the rest in tissues and plasma. Calcium levels are tightly regulated by parathyroid hormone (PTH), calcitonin, and calcitriol (active vitamin D). PTH increases calcium levels by promoting bone resorption, while calcitonin and calcitriol decrease calcium levels by reducing resorption. Bisphosphonates are used to treat osteoporosis and Paget's disease by inhibiting bone resorption. They decrease osteoclast activity and survival. Calcium supplements are used to treat deficiencies and osteoporosis, while bisphosphonates and calcim
Calcium, phosphorus, and potassium are essential minerals that play important roles in bone health, cell signaling, energy production, and other physiological processes. Calcium is critical for bone structure and strength. Phosphorus is also structural and involved in energy production. Potassium helps nerves and muscles function properly. Deficiencies can lead to bone diseases like rickets or osteomalacia. Maintaining adequate intake through diet or supplements is important for prevention of diseases like osteoporosis and kidney stones.
This document provides information on several polysaccharides and their uses. It discusses the following compounds: calcium gluconate, ferrous gluconate, sorbitol, mannitol, glucosamine, ascorbic acid, lactulose, sucralfate, hetastarch, cyclodextrins, chitin/chitosan, heparin, acarbose, hydroxypropyl methylcellulose, and hyaluronic acid. For each compound it provides details on source, mechanism of action, uses, and in some cases toxicity. The document contains information on the preparation and applications of these polysaccharides in pharmacy and medicine.
This document provides information on disorders of the parathyroid glands. It discusses the anatomy and function of the parathyroid glands, including their role in calcium regulation and production of parathyroid hormone (PTH). It describes primary hyperparathyroidism, which results from excessive PTH production, and its clinical features. The document also covers hypoparathyroidism, which is a deficiency of PTH, and its signs, symptoms and treatment with calcium and vitamin D supplementation. In summary, the document outlines key endocrine disorders of the parathyroid glands, their effects on calcium levels, and management approaches for hyperparathyroidism and hypoparathyroidism.
Parathyroid gland and The pituitary and HypothalamusAmany Elsayed
The parathyroid glands produce parathyroid hormone (PTH) which regulates calcium and phosphorus levels in the blood by increasing their absorption in the intestines, resorption in the kidneys, and mobilization from bones. PTH increases calcium levels while decreasing phosphorus. The thyroid gland produces calcitonin which decreases calcium levels. Vitamin D facilitates intestinal calcium absorption. Hyperparathyroidism is excessive PTH production and can be primary from adenomas or hyperplasia, or secondary from low calcium levels due to kidney disease or vitamin D deficiency. Complications include osteoporosis, kidney stones, and heart disease.
Drug acting on Calcium Presentation .pptxDrSeemaBansal
Calcium is an essential mineral that is important for bone health and many other bodily functions. It is regulated in the body by parathyroid hormone (PTH), calcitonin, and calcitriol, the active form of vitamin D. Calcium levels can be affected by drugs that interfere with absorption or excretion. Calcium is supplemented orally or intravenously to treat deficiencies. PTH and calcitriol work to increase calcium levels while calcitonin works to decrease them. Vitamin D helps regulate calcium levels by facilitating absorption in the intestine.
Agents that affect bone mineral homeostasis paulPaul Ndung'u
This document discusses various agents that affect bone mineral homeostasis. Parathyroid hormone (PTH) and vitamin D principally regulate calcium and phosphate levels. PTH stimulates vitamin D production and bone resorption, while vitamin D promotes intestinal absorption of calcium and phosphate. Other agents discussed include calcitonin, bisphosphonates, estrogens, glucocorticoids, thiazides, fluoride, and phosphate binders, which all act on bone formation, resorption, or mineral levels in various ways to maintain bone mineral homeostasis.
Iron, vitamin B12, and folic acid are essential nutrients that play important roles in red blood cell formation and oxygen transport. Iron deficiency is the most common cause of anemia and can cause fatigue. Vitamin B12 and folic acid deficiencies can lead to megaloblastic anemia and neurological issues if left untreated. These vitamins have important interactions and side effects that require monitoring, especially in high risk groups like pregnant women.
This document provides an overview of hypoparathyroidism, including its definition, types, symptoms, diagnosis, and treatment. Hypoparathyroidism is a rare condition where the parathyroid glands do not produce enough parathyroid hormone, resulting in low calcium and high phosphate levels in the blood. There are several types including acquired, autoimmune, congenital, and idiopathic hypoparathyroidism. Common symptoms include muscle spasms, abnormal sensations, and seizures. Diagnosis involves evaluating calcium, phosphate, and parathyroid hormone levels in the blood. Treatment focuses on calcium and vitamin D supplementation to manage symptoms.
This document discusses vitamin D and hyperparathyroidism. It notes that vitamin D is a fat-soluble vitamin that is converted to its active form in the kidney and regulates calcium levels. Hyperparathyroidism occurs when the parathyroid glands overproduce parathyroid hormone (PTH), which regulates calcium levels. There are three types: primary (excess PTH from parathyroid glands), secondary (increased PTH to compensate for hypocalcemia), and tertiary (PTH secretion becomes unregulated even after correcting the underlying cause). The document outlines the causes, clinical features, investigations, and treatments for each type of hyperparathyroidism.
Vitamins and trace elements deficiency.pptxmohithA9
This document discusses vitamins and trace elements. It provides details on several water soluble vitamins (vitamin B complex and vitamin C) and fat soluble vitamins (vitamins A, D, E, and K). Specific vitamins discussed in more depth include thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pyridoxine (vitamin B6), their roles, food sources, deficiency symptoms and treatments. The document provides in-depth information on the classification, functions, deficiency and treatment of several important vitamins.
Healthcare for working women should focus on providing nutritious snacks and lunches to support wellbeing, as diet can impact health and weight. Employers should implement policies and management strategies to promote healthy eating and maintaining a healthy weight for female employees.
This document discusses risk factors for osteoporosis. It defines osteoporosis as a disease causing reduction in bone mass and strength. Some key risk factors include estrogen deficiency, mechanical factors like lack of exercise, tobacco use, and steroid use. It also discusses evaluation of bone mineral density, pathophysiology of different osteoporosis types, and consequences of osteoporotic fractures including significant morbidity and increased mortality rates.
Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased risk of fractures. It is diagnosed based on bone mineral density T-scores obtained via dual-energy X-ray absorptiometry (DXA) scanning. Treatment focuses on lifestyle modifications like calcium and vitamin D supplementation, exercise, and medications to reduce fracture risk such as bisphosphonates. Prevention emphasizes building peak bone mass during childhood and adolescence through adequate nutrition and exercise.
- Diabetic hyperosmolar hyperglycemic state (HHS) is a life-threatening condition characterized by very high blood glucose levels, dehydration, and minimal ketosis. It occurs most often in older adults with type 2 diabetes who become severely dehydrated.
- Treatment involves rapid rehydration with intravenous fluids, bringing down blood glucose levels with insulin, and identifying and addressing the underlying cause to prevent future crises. Fluid replacement of 9-12 liters may be needed over 48 hours.
- Education is important to prevent recurrence through proper blood glucose monitoring and management of predisposing factors like infection, medications, and poor compliance with diabetes treatment.
This document discusses potential complications of diabetes, including both acute and chronic complications. It covers topics such as hyperglycemia, hypoglycemia, diabetic ketoacidosis, retinopathy, nephropathy, neuropathy, cardiovascular disease, and more. It provides details on symptoms, treatments, and ways to manage various complications through lifestyle modifications and medical care. The document is intended as an educational resource for diabetes patients and healthcare providers.
This document provides information on carbohydrate counting for diabetes management. It explains that carbohydrate is the main nutrient that affects blood glucose levels after eating. Counting carbohydrates is an essential skill for people with type 1 diabetes so they can match insulin intake to the amount of carbohydrates consumed and properly manage blood glucose levels. The first step is identifying foods that contain carbohydrates versus those that contain very little, such as meat, eggs, cheese, nuts, oils, and most vegetables. Recommended resources for estimating the carbohydrate content of foods are provided to help count carbohydrates in grams or carbohydrate portions.
This document discusses lipodystrophy syndromes, which are disorders characterized by selective loss or accumulation of adipose tissue. It reviews the classification and clinical features of different lipodystrophy syndromes, with a focus on HIV-related lipodystrophy. Complications of lipodystrophy like insulin resistance, hyperlipidemia and fatty liver are also summarized. The document outlines treatment considerations for managing metabolic complications and reversing lipoatrophy or lipohypertrophy, including switching antiretrovirals, use of thiazolidinediones, statins, metformin and lifestyle changes.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
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We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
2. DEFINITIONS AND BACKGROUND
■ Hypoparathyroidism results from a deficiency of PTH from biologically ineffective
hormones, damage or accidental removal of the glands, or impaired skeletal or renal
response.
■ In the hereditary form, parathyroid glands are either absent or not functioning properly;
symptoms appear before age 10.
■ Other causes include magnesium deficiency or neonatal immaturity.
■ If untreated, hypoparathyroidism- retardation-dysmorphism (HRD) may result.
3. DEFINITIONS AND BACKGROUND
■ Cancellous bone in hypoparathyroidism is abnormal, suggesting that PTH is required to
maintain normal trabecular structure (Rubin et al, 2010).
■ Hypoparathyroidism with hypocalcemia is one of the most common results of damage to
parathyroid glands during surgery; in fact, it may be diagnosed during a workup for
hypocalcemia.
■ Vitamin D levels may also be deficient.
■ Intraoperative PTH levels are used widely during parathyroidectomy as an indicator of
parathyroid gland function; vitamin D supplementation after surgery may be given to
anticipate decreased parathyroid gland function and to avoid symptomatic hypocalcemia
(Quiros et al, 2005).
4. DEFINITIONS AND BACKGROUND
■ Hypoparathyroidism is a chronic condition that requires lifelong treatment with large
doses of calcium and vitamin D supplements.
■ Episodes of tetany are treated with calcium given intravenously to provide quick relief of
symptoms.
■ Controlled release of physiological concentrations of PTH can be achieved using a
surgically implantable controlled- release delivery system (Anthony et al, 2005).
5. INTERVENTION OBJECTIVES
■ Normalize serum and urinary levels of calcium, phosphorus, and vitamin D.
■ Prevent long-term complications such as cataracts, pernicious anemia, Parkinson’s
disease, and bone disease.
■ Prevent mental retardation or malformed teeth in affected children.
■ Decrease symptoms of tetany and improve overall health status.
6. FOOD AND NUTRITION
■ Use a high-calcium diet with dairy products, nuts, salmon, peanut butter, broccoli, and
other green leafy vegetables. If tolerated, lactose should be included in the diet for better
absorption of calcium.
■ Oral supplements high in calcium should be used, such as calcium carbonate.
■ Reduce excess use of meats, phytates (whole grains), and oxalic acid (spinach, chard,
and rhubarb) if the diet contains large amounts.
■ Intake of vitamin D and protein should be adequate, at least meeting recommended
levels.
7. Common Drugs Used and Potential
Side Effects
■ Calcium lactate (8–12 g) may be used. Ergocalciferol (Calciferol) is a vitamin D analog
that is used with calcium supplements in this condition. Calcitriol (Rocaltrol) also may be
useful.
■ Diuretics sometimes are given to prevent too much calcium from being lost through the
urine, which is a problem that can lead to kidney stones. Taking diuretics also reduces
the amount of calcium and vitamin D supplements needed.
■ Overuse of steroids may cause hypocalcemia.
9. NUTRITION EDUCATION,
COUNSELING,
CARE MANAGEMENT
■ Indicate which foods are good sources of calcium, phosphorus, and vitamin D.
■ Indicate which foods are sources of phytates and avoided, if dietary intake is a concern.
■ Discuss role of sunlight exposure in vitamin D formation and how it relates to individual
needs.
12. DEFINITIONS AND BACKGROUND
■ Primary hyperparathyroidism (pHPT) results from parathyroid adenoma in up to 80%
of cases, hyperplasia of the parathyroid glands in 10–20% of cases, or cancer.
■ Double parathyroid adenomas occur in 2–15% of pHPT cases (Abboud et al, 2005).
■ pHPT has been associated with premature death in CVDs and should, therefore, be
quickly managed (Nilsson et al, 2005).
13. DEFINITIONS AND BACKGROUND
■ Secondary hyperparathyroidism (sHPT) occurs in renal failure or even after renal
transplantation.
■ Calcitriol deficiency and phosphorus retention are involved in the pathogenesis.
■ Parathyroid gland hyperplasia develops in azotemic patients, producing hypercalcemia
and hyperphosphatemia.
■ Secondary hyperparathyroidism in chronic kidney disease is stimulated by dietary
phosphate loading and ameliorated by dietary phosphate restriction (Martin et al, 2005).
■ The disorder is complex in that not enough phosphate is cleared from the body;
phosphate is released from bone and Vitamin D is not produced.
■ Thereafter, absorption of calcium in the gut is low and serum levels of calcium are
lowered.
14. DEFINITIONS AND BACKGROUND
■ In children with renal failure, growth can be impaired.
■ Postmenopausal women after Roux-en-Y gastric bypass may show evidence of
secondary hyperparathyroidism with elevated bone resorption.
■ There is an effect of early breast tumors on calcium homeostasis; subclinical
hyperparathyroidism may increase the risk for breast cancer (Martin et al, 2010).
■ Age-induced increased PTH plasma levels have been associated with cognitive decline
and dementia.
■ Increased PTH levels may become a biological marker of both dementia and
osteoporosis (Braverman et al, 2009).
15. DEFINITIONS AND BACKGROUND
■ Parathyroidectomy can induce long-lasting improvement in regulation of BP, left
ventricular diastolic function, and other signs of myocardial ischemia, with improved life
expectancy (Nilsson et al, 2005).
■ A minimally invasive procedure is available.
■ After surgery, mild cognitive changes seem to improve, especially for depression and
anxiety (Walker et al, 2009).
16. INTERVENTION OBJECTIVES
■ Lower elevated serum calcium and urinary calcium levels. Maintain calcium levels
between 8.4 and 9.5 mg/dL.
■ Normalize serum phosphate; keep phosphorus between 3.5 and 5.5 mg/dL and calcium
phosphorus product below 55 mg/dL.
■ Alleviate constipation, anorexia, weight loss, and weakness.
17. INTERVENTION OBJECTIVES
■ Avoid clinical consequences such as renal osteodystrophy, hyperphosphatemia,
cardiovascular calcification, extra- skeletal calcification, endocrine disturbances,
neurobehavioral changes, compromised immune system, altered erythropoiesis, renal
stones, and sleep disturbances.
■ Prevent rickets and growth delay in children (Sabbagh et al, 2005).
■ Prepare for surgery if parathyroidectomy is necessary.
18. FOOD AND NUTRITION
■ Use a low-calcium diet with fewer dairy products, nuts, salmon, peanut butter, and green
leafy vegetables.
■ Extra fluid is useful to correct or prevent dehydration, which can elevate serum calcium
levels.
■ Limit phosphorus-containing foods if hyperphosphatemia is present.
■ Use alternatives such as nondairy creamer, sorbet, jams and jellies, white rice, noodles
with margarine, cream cheese, whipped cream, popcorn, pretzels, gingerale or Koolaid if
extra calories are needed.
■ Dietary protein 0.8 g/kg for a balanced intake of protein in adults.
19. Common Drugs Used and
Potential Side Effects
■ Vitamin D therapy sends a signal to the parathyroid gland to slow down the making of
PTH. This helps to prevent many of the unwanted complications of hyperparathyroidism.
20.
21. Common Drugs Used and Potential
Side Effects
■ Treatment with active vitamin D from analogs can increase VDR expression, inhibit
growth of parathyroid tumors, and reduce PTH levels (Akerstrom et al, 2005). Zemplar
(paricalcitol) and Hectorol (doxercalciferol) are examples of vitamin D analogs. These
products are especially useful for dialysis patients.
■ Cinacalcet (Sensipar) has been approved to treat sHPT in renal patients and parathyroid
cancer. It also appears to effectively treat pHPT. Cinacalcet normalizes serum calcium
with only modest increases in PTH (Sajid-Crockett et al, 2008).
■ Phosphate-binding agents that do not contain calcium offer therapeutic alternatives for
managing renal osteodystrophy. Sevelamer (Renagel) lowers serum phosphorus and
PTH levels without inducing hypercalcemia. Sevelamer binds drugs such as furosemide,
cyclosporine, and tacrolimus, making them less effective. The timing of administration
should allow several hours between these medicines. Standard protocols are
recommended for use of phosphate binders.
22. Common Drugs Used and Potential
Side Effects
■ Once-yearly intramuscular cholecalciferol injections (600,000 IU) have been used to
correct vitamin D deficiency; controlled trials are needed to determine the effect on PTH
levels over time.
■ Some antacids may contain high levels of calcium; monitor carefully.
■ Bisphosphonates may be needed to decrease risks for osteoporosis.
23. Herbs, Botanicals, and
Supplements
■ Herbs and botanical supplements should not be used without discussing with physician.
■ Conjugated linoleic acid (CLA) reduces prostaglandin E2 synthesis, which is required for
PTH release. More research is needed.
24. NUTRITION EDUCATION,
COUNSELING,
CARE MANAGEMENT
■ Discuss foods that are sources of calcium, phosphorus, and vitamin D. Indicate food
sources of phytates and oxalates, if intake is a concern.
■ Discuss role of sunlight exposure in vitamin D formation and how it relates to individual
needs.
■ Drink plenty of liquids.
25. NUTRITION EDUCATION,
COUNSELING,
CARE MANAGEMENT
■ In renal patients, focused counseling may help to clarify misunderstanding of simple
dietary facts.
■ The doctor should monitor Ca++ and P monthly and PTH quarterly after stabilization.
■ Exercise and smoking cessation may be needed.
28. DEFINITIONS AND BACKGROUND
■ The metabolic syndrome (MetS; insulin resistance syn- drome or syndrome X) has
simultaneous clustering of low levels of HDL cholesterol, hyperglycemia, high waist
circumference, hypertension, and elevated triglycerides. Any three of the following five
criteria constitute diagnosis of MetS (Grundy et al, 2005):
➤ Elevated waist circumference: 40’’ or 102 cm in men; 35’’ or 88 cm in women.
➤ Elevated triglycerides (TG) ≥150 mg/dL or drug treatment for elevated TG.
➤ Reduced HDL cholesterol: <40 mg/dL in men and 50 mg/dL in women or drug
treatment for low HDL cholesterol levels.
➤ Elevated BP: >130 mm Hg systolic BP or 85 mm Hg diastolic BP or drug treatment for
hypertension.
➤ Elevated fasting glucose: >100 mg/dL or drug treatment for elevated glucose.
29. ■ It is associated with CVD and often leads to T2DM.
■ This condition affects some young people but usually affects persons aged 55 years and
older.
■ More than 64 million Americans have MetS, roughly one in four adults and 40% of adults
aged 40 years and older.
■ Increased birthweight, excessive energy intake, physical inactivity, obesity, smoking,
inflammation, and hypertension contribute to MetS.
■ Individuals who are obese and insulin resistant are particularly prone to this syndrome.
■ An “apple” shaped figure (high waist circumference) is riskier because fat cells located in
the abdomen release fat into the blood more easily than fat cells found elsewhere.
DEFINITIONS AND BACKGROUND
30. ■ Serum adiponectin levels are associated with insulin sensitivity; they are decreased in
T2D and obesity. Genetic and environmental factors contribute to risk (Gable et al, 2006).
■ The initial insult in adipose inflammation and insulin resistance is perpetuated through
chemokine secretion, adipose retention of macrophages, and elaboration of pro-
inflammatory adipocytokines (Shah et al, 2008).
■ In women, depressive symptoms are associated with MetS, especially with elevated
afternoon and evening cortisol (Muhtz et al, 2009). Clearly, more research is needed.
DEFINITIONS AND BACKGROUND
31. ■ Management of MetS should focus on lifestyle modifications, especially reduced caloric
intake and increased physical activity (Deedwania and Volkova, 2005).
■ Phytochemicals, MUFA, antioxidant foods, spices such as turmeric, cumin, and cinnamon
have anti-inflammatory effects.
■ Intake of whole milk, yogurt, calcium, and magnesium protect against MetS whereas
intake of cheese, low-fat milk, and phosphorus do not (Beydoun et al, 2008; McKeown et
al, 2009).
DEFINITIONS AND BACKGROUND
32. INTERVENTION OBJECTIVES
■ Reduce the inflammatory state and insulin resistance caused by excessive adipose
tissue. Improve body weight; lessen abdominal obesity in particular. A realistic goal for
weight reduction should be 7–10% over 6–12 months (Bestermann et al, 2005).
■ Promote physical activity. Recommendations should include practical, regular, and
moderated regimens of exercise, with a daily minimum of 30–60 minutes and equal
balance between aerobic and strength training (Bestermann et al, 2005).
■ Achieve and maintain cholesterol, blood glucose, and BP at levels indicated by the
American Heart Association, as follows (Grundy et al, 2005):
33. For Atherogenic Dyslipidemia
■ For elevated LDL cholesterol: Give priority to reduction of LDL cholesterol over other lipid
parameters. Achieve LDL cholesterol goals based on patient’s risk category. LDL
cholesterol goals for different risk categories are:
➤ High risk: seek 70–100 mg/dL
➤ Moderately high risk: seek 100–130 mg/dL
➤ Moderate risk: seek 130 mg/dL
➤ Lower risk: 160 mg/dL is acceptable
34. For Atherogenic Dyslipidemia
■ If TG is >200 mg/dL, then goal for non-HDL cholesterol for each risk category is 30 mg/dL
higher than for LDL cholesterol. If TG is >200 mg/dL after achieving LDL cholesterol goal,
consider additional therapies to attain non-HDL cholesterol goal.
■ If HDL cholesterol is <40 mg/dL in men or <50 mg/dL in women, raise HDL cholesterol to
extent possible with standard therapies for atherogenic dyslipidemia. Either lifestyle
therapy can be intensified or drug therapy can be used for raising HDL cholesterol levels,
depending on patient’s risk category.
35. For Elevated BP
■ Reduce BP to at least achieve BP of >140/90 mm Hg (or <130/80 mm Hg if diabetes is
present). Reduce BP further to extent possible through lifestyle changes.
■ For BP >120/80 mm Hg: Initiate or maintain lifestyle modification via weight control,
increased physical activity, sodium reduction, and emphasis on increased consumption of
fresh fruits, vegetables, and low-fat dairy products in all patients with MetS.
■ For BP >140/90 mm Hg (or >130/80 mm Hg if diabetes is present), add BP medication as
needed to achieve goal BP.
36. For Elevated Glucose
■ For IFG, delay progression to T2DM. Encourage weight reduction and increased physical
activity.
■ In diabetes, for hemoglobin A1 c at or above 7.0%, lifestyle therapy and
pharmacotherapy, if necessary, should be used. Modify other risk factors and behaviors
(e.g., abdominal obesity, physical inactivity, elevated BP, or lipid abnormalities).
37. For Prothrombotic State
■ Reduce thrombotic and fibrinolytic risk factors. Low dose aspirin therapy or prophylaxis is
recommended.
38. For Proinflammatory State
■ There are no specific therapies beyond lifestyle changes. The antioxidants and omega-3
fatty acids may be helpful.
39. FOOD AND NUTRITION
■ The general recommendations include low intake of saturated fats, trans fats, and
cholesterol. Increase use of omega-3 PUFA intake (Shen et al, 2007) and MUFA
(especially extra virgin olive oil).
■ Plan a Mediterranean-type diet using more fiber and starches, especially whole grains,
raw fruits, and vegetables. A plant-based diet may be useful (Barnard et al, 2005).
■ The DASH diet contains 3–4 g sodium with good sources of potassium, calcium, and
magnesium. Dairy products provide calcium, magnesium, and potassium.
■ Monitor blood glucose levels. Carbohydrate restriction (CR) has been shown to improve
dyslipidemias associated with MetS more than a low fat diet (Al-Sarraj et al, 2010).
40. ■ Encourage soy protein as a meat substitute several times a week; soy protein may help
with weight reduction and dyslipidemia (Bestermann et al, 2005).
■ Ensure adequate intake of folate, vitamins B6, B12, C, and E, preferably from food.
■ Dark chocolate in small amounts regularly may help lower BP, improve cholesterol, and
help with insulin sensitivity.
■ Spread out the energy load by eating smaller meals.
FOOD AND NUTRITION
41. Common Drugs Used and Potential
Side Effects
■ To lower lipids, a statin should be used initially unless contraindicated (Bestermann et al,
2005).
■ Statins decrease biomarkers of inflammation and oxidative stress in a dose-related
manner; atorvastatin 80 mg compared with a 10-mg dose is superior for decreasing
oxidized LDL, hsCRP, matrix metalloproteinase-9, and NF-kB activity (Singh et al, 2008).
■ Glucose-lowering medications must be carefully prescribed and monitored. Metformin
may be indicated (Orchard et al, 2005).
42. Common Drugs Used and Potential
Side Effects
■ BP medications may be prescribed; monitor for necessary restrictions of sodium and/or
higher need for potassium. An ACE inhibitor or an angiotensin receptor blocker is usually
the first medicine (Bestermann et al, 2005).
■ Medications that diminish insulin resistance and directly alter lipoproteins are necessary;
combination therapy is often required (Bestermann et al, 2005).
■ If patients with MetS have elevated fibrinogen and other coagulation factors leading to
prothrombotic state, aspirin is used (Deedwania and Volkova, 2005).
■ Low-dose aspirin is not generally a problem; taken with a meal or light snack to prevent
potential for GI bleeding.
43. Herbs, Botanicals, and
Supplements
■ Antioxidant supplements are not recommended, but intake of antioxidant-rich foods
should be suggested (Czernichow et al, 2009).
■ Thus far, trials with alpha tocopherol have been disappointing; further trials with gamma
and alpha-tocopherols are warranted.
■ Include phytochemcals, antioxidant foods, and spices such as turmeric, cumin, and
cinnamon in the diet.
■ Chromium picolinate (CrPic) enhances insulin action by lowering plasma membrane (PM)
cholesterol (Horvath et al, 2008).
■ Coenzyme Q10 may have some merit, but further research is needed.
44. Herbs, Botanicals, and
Supplements
■ High serum selenium concentrations have been associated with prevalence of higher
FPG, LDL, TG, and glycosylated hemoglobin levels; further research is needed to
determine its role in the development or the progression of MetS (Bleys et al, 2008).
■ Other herbs and botanical supplements should not be used without discussing with
physician.
45. NUTRITION EDUCATION,
COUNSELING, CARE
MANAGEMENT
■ Widespread screening is recommended to slow the growth of this syndrome.
■ Prevention should start in childhood with healthy nutrition, daily physical activity, and
annual measurement of weight, height, and BP beginning at 3 years of age (Bestermann,
2005).
■ Discuss the role of nutrition (DASH or Mediterranean diet principles) in managing this
syndrome.
■ Obesity is a major contributor to the problem, so weight loss (even 10 lb) can help
improve health status.
■ A diet rich in antioxidants and DHA is beneficial. Finally, the 2005 Dietary Guidelines are
consistent with lowering risk for MetS (Fogli-Cawley et al, 2007).
46. NUTRITION EDUCATION,
COUNSELING, CARE
MANAGEMENT
■ Regular physical activity can help to lower elevated blood cholesterol levels and BP.
■ Walking, or an exercise that is pleasant for the individual, is the one to select. Aerobic
and strength training exercises are beneficial.
■ Reduce sedentary activities, including television and computer time (Ford et al, 2005).
■ Smoking cessation measures may be needed. Offer guidance on how not to gain weight
after quitting.